Professor Wallace Fox

Professor Wallace Fox, who has died aged 89, was director of the Medical
Research Council (MRC) Tuberculosis and Chest Diseases Unit and a physician
with outstanding breadth of vision; worldwide his work led to the
establishment of effective treatments for tuberculosis, both in developed
and developing countries, helping to save millions of lives.

Wallace Fox was born on November 7 1920 in Bristol, where he went to Cotham Grammar School. He trained at Guy's Hospital, London, qualifying in 1941.

But his life was turned upside down when he contracted TB – at a time when more than half those who developed the disease died of it.

He was treated with bed rest for two years in the Bristol Royal Infirmary. This personal experience stimulated his lifelong interest, some would say obsession, with TB.

After clinical posts at Preston Hall Sanatorium, Guy's Hospital and Hammersmith Chest Clinic, Fox joined the staff of the MRC Tuberculosis Research Unit, directed by Philip D'Arcy Hart, in 1952. At this time several antibacterial drugs were being introduced which seemed likely to be effective. But when used they singly, drug-resistant bacteria were found to emerge, rendering treatment ineffective.

Fox's trials showed that resistance could be prevented if the drugs were mixed. This was a major breakthrough, and combinations of drugs (streptomycin with isoniazid or para-aminosalicylic (PAS) acid given for between one and two years) became the standard regimen in developed countries.

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Because PAS was expensive it was unavailable in many poor countries. Collaborating with physicians in east Africa, Fox solved the cost problem through studies which found that the antibiotic thiacetazone was a cheap and effective alternative. This substitute was subsequently widely used in Africa and in other parts of developing world.

In 1956 Fox went to India, where he married Gaye Akker, and set up a Tuberculosis Chemotherapy Centre in Madras which he directed for five years. He carried out a study comparing the results of chemotherapy given in a sanatorium with rest and good diet with chemotherapy given at home, in conditions of poverty, overcrowding and poor diet.

This showed no advantage for the sanatorium group and no added risk of infection for the family members of those treated at home – a landmark realisation which revolutionised the management of the disease, enabling TB sanatoria worldwide to be closed. Fox then devised a programme of supervised medication that ensured treatment continued to be as effective at home as it had been in hospitals.

After returning to London, in 1965 Fox was appointed director of the MRC Tuberculosis and Chest Diseases Unit at the Royal Brompton Hospital, where he was honorary consultant physician and subsequently Professor of Community Therapeutics at what is now the National Heart and Lung Institute.

There he was the driving force in the development of a programme of clinical trials and epidemiological surveys involving many collaborators worldwide. New drug regimens were tested in the most adverse conditions, including among nomadic Bedouin tribes in the Sahara.

Other studies resulted in major advances in the treatment of TB of the spine and pericardium and Fox also contributed to work on the management of asthma and lung cancer in association with Margaret Turner-Warwick at the Royal Brompton. Those working on his unit appreciated his integrity, single-mindedness, encouragement, kindness and humour. His special talent was in gaining the confidence and co-operation of his associates.

He played a leading role at the World Health Organisation (WHO) and in the International Union Against Tuberculosis. He received many national and international honours, medals and awards, and was appointed CMG.

Fox was a man of great learning and broad interests, including art, classical music, literature, history, geology and palaeontology. His active engagement in these pastimes in his retirement was curtailed by the onset of Alzheimer's disease. He remained physically strong, however, and retained his lifelong traits of determination and assertiveness.

Wallace Fox, who died on January 22, is survived by his wife, an accomplished artist, and their three sons.